Last chance for Medicare, Medicaid reform? Nope

With the current uncertainty, the law was “untouchable” for the supercommittee — but it “won’t be forever,” according to Douglas Holtz-Eakin, a former John McCain adviser and president of the conservative American Action Forum.

The alternative really has to be worse. The whole idea of the “trigger” — the automatic cuts in health care and defense — was to present a scenario so drastic that the supercommittee would have to reach a deal. But that seems to have been true only on defense, where some Republicans are now talking about trying to undo the trigger before the cuts take place.

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On health care, it was never clear to health industry lobbyists that the automatic cuts actually were the worst scenario. They knew what to expect — $123 billion in Medicare payment cuts — and there were supercommittee scenarios that could have hurt them more.

“The bottom line is that most of the proposals they’ve been talking about, about reforming Medicare, were significantly more than that,” said G. William Hoagland, vice president of public policy at CIGNA, who was a top budget aide to former Senate Majority Leader Bill Frist. Since the across-the-board Medicare cuts would have been capped at 2 percent, Hoagland said, there always would have been health industry lobbyists saying they were “better off with the across-the-board cuts than fundamental reforms to Medicare.”

And since the automatic cuts were going to happen anyway, the supercommittee had an option where the members didn’t have to do anything at all.

“The assumption was that the trigger would have been so onerous that it would have forced them to make a deal. It isn’t at all clear that that language wasn’t backwards and wrong,” said Altman of the Kaiser Family Foundation.

The public has to be ready. That’s the element that’s least likely to change after the elections, though. Polls consistently show the public wants to reduce the deficit but doesn’t want to touch entitlements like Medicare and Medicaid — a contradiction that always makes lawmakers’ jobs harder, Wilensky said.

Even if the other elements of a deal come together, the public’s mood will always be the biggest obstacle if the election doesn’t give the president and Congress a clear go-ahead.

“Whether the American public and its leaders will be willing to have this kind of discussion after 2012 is unclear,” Wilensky said. “The more politicians are led to make unreasonable promises to get elected, the harder it will be. Eventually we will be forced to make these changes.”

“We’ll see. But it’s hard not to be discouraged.”

Jennifer Haberkorn contributed to this report.

This article first appeared on POLITICO Pro at 5:30 a.m. on Nov. 22, 2011.

CORRECTION: A previous version of this story misstated the party affiliations of House Ways and Means Committee Chairman Dave Camp and House Energy and Commerce Committee Chairman Fred Upton. They are Republicans.

Readers' Comments (97)

Oh, let's just tell it like it is. The idea that a so-called "supercommittee" would somehow find a middle ground was ludicrous from the start. There is no middle ground.

The Tea Party is dragging the Republican Party, kicking and screaming, back to the Constitutional principles upon which this country was founded. Meanwhile, the marxists who have co-opted the Democratic party are dragging it into socialism. The middle ground is disappearing, and rightly so.

We have seen the results of compromising with socialism. Nearly 10% unemployment, $15 trillion debt, trillion dollar deficits annually, and no end to any of this is in sight. For two years we had socialists in charge of the executive branch, and both houses of Congress. The results were an unmitigated disaster. Time for a return to the capitalist ideas that made this the richest country in history.

Americans are being lied to about the deficit - Opinion - Al Jazeera ... www.aljazeera.com/indepth/opinion/.../2011112271316280749.html 42 minutes ago – Republicans want to gut social safety nets, not cut the US deficit.

The "Founders" wanted a closed circle of wealthy land owners, wealthy slave owners to have ALL the Power ...

Both The Constitution & The Electoral College were designed to keep what YOUR Founding Fathers thought to be mob-rule (democracy) out of the game... thus, we get a Jeffersonian plan + Madison's Electoral College and Hamilton's Tax System...

Wake Up Tea-Party-Activists = Top Republicans follow Madison's view of who should be King over you ....and it's not you . . .

The time is rapidly approaching where political "war" is going to be the only way to deal the the rapidly-widening chasm. One side or the other will have to be utterly destroyed before this nation can make a definitive move back to the constitutional republic our founders left to us, or we go the way of Europe, into a vast socialist wasteland.

It's going to be painful and ugly, but, I'm afraid that's about the only viable option left. Let's hope the forces of liberty can prevail.

Medicare and Medicaid Reform? Absolutely - in any structural way that insures the solvency and security of these vital public sector programs. That will include increases in FICA taxes or a movement away from an employer based healthcare insurance format. That will include increased reforms in Healthcare Affordability. What it cannot - CANNOT - include is the utter falseness of reduced benefits, "privitization," and "block grants to the states." The republican party is not a credible reform agent when their primary objective remains the destruction of these programs.

NOBODY SEEMS TO GET IT!!! WE'VE BEEN LIED TO AND CHEATED!!! THERE AIN'T NO MONEY LEFT!!! THE REPROBATES IN BOTH PARTIES HAVE ALREADY SPENT IT!!! I'M A HARD-WORKING SELF-EMPLOYED FOOL WHO HAS ALWAYS PAID INTO SOCIAL SECURITY~ BUT, I'VE ALWAYS SAID THAT I DON'T EXPECT TO EVER BE ABLE TO DRAW A DIME, BECAUSE THE MATH IS IMPOSSIBLE!!! IT'S ALWAYS BEEN AN OBVIOUS AND CLASSIC PONZY SCHEME~ IT FITS THE DEFINITION PERFECTLY!!!

Well, now you know who the Anti-Christ is...Grover Norquist. He wants to kill our country, because he secretly hates Americans. His wife is Muslim, and he is believed to have ties with the Islamic Brotherhood Society. Go look it up. He is so radical that it gives me nightmares. My insight is on overdrive. The poll got it right here...the Republicans are to blame for this crap. If we all came together, and taxed the millionaires, and others who could afford it, plus made mild cuts to medicare, and SS, and defense we wouldn't even be having this conversation. The GOP designed this awful plan, and it's their fault...automatic cuts and all. Defense can be quite expensive...so we need taxes to fund it. Same goes for Medicare, SS, and Medicaid. It's time we take care our of people, and quit being so greedy. I laugh at their profession of Faith. They just don't walk the walk. Our President is just the opposite. He doesn't talk the talk much, but he sure walks the walk. If you read his books, and biography you would know what the truth is. He discovered Christianity later in his life, and he prays a lot, but prefers to do it in private. Read the gospels Matthew, Mark, Luke and John. You'll know I'm right. You don't take care of the poor, and our parents...seniors, etc. it's down to the fiery depths of Lucifer's abode. The signing of a no tax pledge is pretty much a demonic pact. Now, you know why they are the "do nothing Congress". However, there are some Democrats that should get thrown out on the asses too. They are "blue dogs", and defectors from the Party. So, we don't have a majority of anything now. Our President can't lead...he's been cut off. He already, thank God, has led by executive order. But even that's limited. Romney's running around with this...He can't lead, he can't lead, etc. That's crap and he knows it. If the people don't vote these clowns out of the legislative office, even he won't get anything done, if he is elected.

Our country is heading towards bankruptcy just like Greece and the other European welfare economies. In President Obama's 10 year budget submitted to Congress earlier this year, deficits ran an average of $1 trillion a year, due to ever increasing spending on entitlement programs, including Social Security, Medicaid, Medicare and Obamacare. The House Republicans passed a budget plan which included recommendations for entitlement reform that would cut $6 trillion of this growth and put us on a path to a balanced budget. The President lampooned this plan and the Senate Democrats failed to even vote on it. In fact, it has been more than 900 days since the Senate even passed any sort of budget. Politicians have made promises they couldn't keep to the American people. Now they lack the courage to fix the problem and are looking for an easy way out. There is NO easy way. There is no way to solve the problem just by increasing taxes on millionaires and billionaires, no matter what this President says. Next November we need to elect representatives with the courage of their convictions who will honestly attack these problems, openly not behind closed doors, and enlist the support of all serious American citizens in fixing our fiscal problems for us, our kids and grandkids.

"Better timing"? Bull. This was the perfect time. Both sides could have helped themselves. But the Dems wanted an issue. And now they have one.

Sadly for the Dems, the public knows that the Medicare and Medicaid programs must be reformed. They know the programs will fail unless changes are made, and made soon. They know that it is the Dems who have blocked every chance to reform these programs.

There is nothing wrong with Medicare. t's working perfectly. Whats's broken is the health insurance system. Get rid of the for-profit health insurance and do what the rest of the western world has done. Why do we think that we are smarter than Canada, Japan, GB, Germany, France...? What do we know that they don't?

Let's be honest. This is really about the escalating cost of health care as Laura Tyson and other prominent economists keep pointing out. With this debate, we seemed to be facing a false choice. Option one from the Republicans, was to throw 30 million seniors (and 70 million Baby Boomers) under the bus. That was never going to happen because those two blocs control most elections and any political leader supporting that positions would be looking for other work after the next election. Option two, from the Democrats, was to raise taxes. That also was never going to happen. First, it's not popular with the public and second there isn't enough money to keep funding the current bloated health care system.

Other developed nations manage this problem at about one third less of their GDP invested in health care than we do. They do so by ensuring everyone is covered (mandates--individual or otherwise) and they keep a lid on the unit prices of goods and services through various mechanisms. By the way, this includes the Swiss and Dutch systems which are routinely touted as international models for the US by conservative pundits. We can't fix the public sector programs like Medicare and Medicaid in a vacuum and we can't fix health care without applying the only cures that have been actually shown to work in real world settings.

#1 FoxFan stated "The Tea Party is dragging the Republican Party, kicking and screaming, back to the Constitutional principles upon which this country was founded. Meanwhile, the marxists who have co-opted the Democratic party are dragging it into socialism. The middle ground is disappearing, and rightly so."

No doubt you are indeed a big fan of Fox News: “All the news you ever wanted just the way you wanted to hear it.” This should not be a dumb debate about "Capitalism versus Socialism," though the "Tea Party" and others seem to believe that simply uttering the word "Socialism" means they have won whatever the debate. This should be a debate about healthcare and the affordability of healthcare. Nobody is talking about government ownership of hospitals or healthcare providers, though in the limited instances where this has been the case, such as local and state owned hospitals VA, the Veteran's Administration has been at least as effective as the "private sector." "Hell yes for profit" healthcare insurance and private hospital industries did not begin in any substantial way in this nation until the 1970's,when entrepreneurs promised that "sound business principals and free markets" would hold down the cost of healthcare." That was a lie. Healthcare insurance giants are among the greatest liars, opposing reforms to protect profits while accusing the government in public of all the things the insurance companies have done in private, ie "rationing healthcare" and "death panels."

The United States cannot credibly claim the "best" healthcare system in the world when access is most limited. The United States can claim the most profitable healthcare system in the world.

There has ever been a public service sector of this economy and not for profit services. If calling this "socialism" leads you to feel righteous and victorious, so be it. You have yet to even enter into serious discussion of the problems and issues in the name of making a lot of money off sick folks.

I grew up in a rural conservative Christian church where World War II and Korean War veterans worshiped and taught. They believed that this was too blessed a country for any child ever to go to bed hungry or anyone ever to go without the health care they needed. They were hardly “socialist,” but they supported community owned not-for profit hospitals and the public schools. They built a Volunteer Fire Department. The built the library, insured that the trash got picked up, and put together public utility services. They believed in the county. So do I.

I just wonder what Congress will do with the multi-billions in dollars saved from the ending of that stupid, useless war in Iraq? My answer is.....waste it on other irrelevant, wasteful programs. Such a sorry ,incompetent bunch of idiots trying to run our government I have never seen in my 74 years.